Journal of Public Health

, Volume 27, Issue 1, pp 63–76 | Cite as

Tracking the efficacy of the test and treat model of HIV prevention in India using National Family Health Surveys (2005–16)

  • Shri Kant Singh
  • Santosh Kumar SharmaEmail author
  • Deepanjali Vishwakarma
Original Article



This paper aims to track the efficacy of the Test and Treat model of human immunodeficiency virus (HIV) prevention adopted by the government of India, 2015–16, using the last two rounds of National Family Health Survey, providing community-based insights in the testing of HIV prevalence in 2005–06 and 2015–16.


The survey collected information from a nationally representative sample of 69,751 men and 124,385 women in 2005–06 and 103,411 men and 121,118 women age 15–49 in 2015–16 respectively. Both descriptive and multivariate techniques have been used.


The 'test and treat' model of HIV in India portrays a women-centric effort to ensure HIV testing as part of their ANC, resulting in a substantial increase in ever being tested for HIV. Women who are educated, living in urban areas, and in economically better households are more prone to have ever undergone HIV testing, it is a welcome change given the existing HIV scenario, with a continuously narrowing gender gap in new HIV infections (NFHS-4). Women and men having positive attitude towards stigma and discrimination to people living with HIV (PLHIV) are in better agreement to ever being tested. Further, women and men having knowledge about antiretroviral therapy (ART) are 1.6 times (p < 0.001) and 1.8 times (p  < 0.001) more likely to have ever been tested for HIV.


Despite an improvement in coverage of HIV testing, the existing disparities in HIV testing and treatment require policy instruments with an integrated approach. Government should work in close collaboration with communities/key stakeholders, and efficiently use their resources to provide evidence-based HIV prevention and treatment interventions.


HIV testing Treatment Test and treat model HIV prevention Gender India 



National Family Health Survey


People living with HIV


Antenatal care visit


Human immunodeficiency virus


Antiretroviral therapy



The authors of this papers are thankful to the participants. The paper did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest statement

The authors of this paper declare that they have no conflict of interest.


  1. Anthony OK, Adetayo T, Folajinmi O, Onu Eugene A, Uchendu O, Ikenna N, Ogbang D (2016) Gender and HIV testing service uptake: trend in northern Nigeria. J AIDS Clin Res 7:638. CrossRefGoogle Scholar
  2. EDHS (Ethiopia Demographic and Health Survey) (2011) Central Statistical Agency [Ethiopia] and ICF International 2012.  Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International. Retrieved from Accessed 15 Feb 2018
  3. EDHS (Ethiopia Demographic and Health Survey) (2005) Central Statistical Agency [Ethiopia] and ORC Macro 2006. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro.[23June2011].pdf. Accessed 15 Feb 2018
  4. Gahagan J (2012) Gender matters in HIV prevention. Accessed 15 Feb 2018
  5. Hendriksen E, Hlubinka D, Chariyalertsak S, Chingono A, Gray G, Mbwambo J, Richter L, Kulich M, Coates TJ (2009) Keep talking about it: HIV/AIDS-related communication and prior HIV testing in Tanzania, Zimbabwe, South Africa, and Thailand. AIDS Behav 13(6):1213–1221. CrossRefPubMedCentralGoogle Scholar
  6. Joseph S, Kielmann K, Kudale A, Sheikh K, Shinde S, Porter J, Rangan S (2010) Examining sex differentials in the uptake and process of HIV testing in three high prevalence districts of India. AIDS Care 22(3):286–295CrossRefGoogle Scholar
  7. Joy H (2017) New Therapy for All HIV Infected People: Nadda. Medindia AIDS/HIV News. 29 April. Retrieved from Accessed 15 Feb 2018
  8. Kishor S, Gupta K (2009) Gender equality and women’s empowerment in India. National Family Health Survey (NFHS-3), India, 2005–2006. International Institute for Population Sciences and ICF Macro, Mumbai and Calverton, Maryland, USA. Accessed 15 Feb 2018
  9. Leta TH, Sandøy IF, Fylkesnes K (2012) Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey. BMC Public Health 12:438. CrossRefPubMedCentralGoogle Scholar
  10. MacPhail C, Pettifor A, Moyo W, Rees H (2009) Factors associated with HIV testing among sexually active South African youth aged 15–24 years. AIDS Care 21(4):456–467.
  11. Malavé S, Ramakrishna J, Heylen E, Bharat S, Ekstrand ML (2014) Differences in testing, stigma, and perceived consequences of stigmatization among heterosexual men and women living with HIV in Bengaluru, India. AIDS Care 26(3):396–403. CrossRefGoogle Scholar
  12. Millennium Developments Goals (MDGs), India Country Report (2015) Government of India, Ministry of Statistics and Programme implementation Central Statistics Office (Social Statistics division). Accessed 15 Feb 2018
  13. Ministry of Health and Family Welfare (MoHFW) (2017) Health Ministry launches ‘Test and Treat Policy for HIV’. Press Information Bureau. Government of India. April, 28, 2017 Accessed 15 Feb 2018
  14. National AIDS Control Organization (NACO) (2016a) Annual Report 2015–16 Pg. 366 Accessed 15 Feb 2018
  15. National AIDS Control Organization (NACO) (2016b) National HIV Counselling and Testing Services (HCTS) Guidelines December Accessed 15 Feb 2018
  16. Ompad DC, Strathdee SA, Kellam C, Latin DD, Celentano JP, Ialongo N (2002) Ethnic and gender differences in HIV testing among urban, economically disadvantaged adolescent in Baltimore, Maryland. International AIDS Conference held at Johns Hopkins University of Public Health, Baltimore, United States during July 7-12; 2002Google Scholar
  17. Rosen S (2016) HIV ‘test and treat’ strategy can save lives—but it needs to be easier for patients to start treatment. Accessed 15 Feb 2018
  18. Snow R, Madaleni M, Poulsen M (2010) Are men testing? Sex differentials in HIV testing in Mpumalanga province, South Africa. AIDS Care 22(9):1060–1065. CrossRefGoogle Scholar
  19. Tanwar S, Rewari BB, Rao CD, Seguy N (2016) India's HIV programme: successes and challenges. J Virus Erad 2(Suppl 4):15–19PubMedCentralGoogle Scholar
  20. Teklehaimanot HD, Teklehaimanot A, Yohannes M, Biratu D (2016) Factors influencing the uptake of voluntary HIV counselling and testing in rural Ethiopia: a cross sectional study. BMC Public Health 16:239. CrossRefPubMedCentralGoogle Scholar
  21. UNAIDS (2014) Ambitious treatment targets: writing the final chapter of the AIDS epidemic. United Nations Joint Programme on HIV/AIDS, Geneva Accessed 15 Feb 2018
  22. UNAIDS (2016a) Fast-track: ending the AIDS epidemic by 2030. Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland Accessed 15 Feb 2018
  23. UNAIDS (2016b) Prevention Gap Report. Accessed 15 Feb 2018
  24. UNGASS (2015) Narrative country progress report of India: Global AIDS Response Progress Reporting 2015. Accessed 15 Feb 2018
  25. United Nations Special Session on HIV/AIDS Fact Sheet (2001) Gender and HIV. Accessed 15 Feb 2018
  26. Viera AJ, Garrett JM (2005) Understanding inter observer agreement: the kappa statistic. Fam Med 37(5):360–363Google Scholar
  27. Wagner BG, Blower S (2012) Universal access to HIV treatment versus universal ‘test and treat’: transmission, drug resistance & treatment costs. PLoS One 7(9):e41212. CrossRefPubMedCentralGoogle Scholar
  28. WHO (2015) Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV.;jsessionid=EEC828A171B8E39AAC190F718CDD695B?sequence=1. Accessed 15 Feb 2018
  29. WHO/UNAIDS (2017) WHO, UNAIDS statement on HIV testing services: new opportunities and ongoing challenges. Accessed 15 Feb 2018
  30. Wringe A, Isingo R, Urassa M, Maiseli G, Manyalla R, Changalucha J, Mngara J, Kalluvya S, Zaba B (2008) Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment. Trop Med Int Health 13(3):319–327. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Shri Kant Singh
    • 1
  • Santosh Kumar Sharma
    • 2
    Email author
  • Deepanjali Vishwakarma
    • 2
  1. 1.Department of Mathematical Demography and StatisticsInternational Institute for Population SciencesMumbaiIndia
  2. 2.International Institute for Population SciencesMumbaiIndia

Personalised recommendations